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肠瘘伴反复发作性腹膜炎与腹膜透析相关:病例报告。

Intestinal fistula accompanied by recurrent peritonitis associated with peritoneal dialysis: a case report.

机构信息

Department of Nephrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, 210008, China.

出版信息

BMC Gastroenterol. 2020 May 24;20(1):157. doi: 10.1186/s12876-020-01303-1.

Abstract

BACKGROUND

Intestinal perforation from peritoneal dialysis is rare, but the resulting complications are serious. Some patients do not necessarily have symptoms, and it can be difficult to differentiate their condition from PD-related (peritoneal dialysis-related) peritonitis, which may lead to misdiagnosis. Here we report a peritoneal dialysis patient with intestinal fistula associated with recurrent peritonitis.

CASE PRESENTATION

A 44-year-old man had been treated for more than 6 years with peritoneal dialysis for chronic kidney disease stage-V. Abdominal computed tomography and electronic colonoscopy revealed an appendiceal fossa with adjacent fistula. The peritoneal dialysis catheter was removed, and the patient recovered with no recurrence of complications.

CONCLUSION

We report a case of a rare complication of peritoneal dialysis. The intestinal fistula in this patient was mainly caused by recurrent peritonitis and removal of the catheter could control the peritonitis.

摘要

背景

腹膜透析导致肠穿孔较为罕见,但由此引发的并发症却很严重。部分患者不一定有症状,且其病情与 PD 相关(腹膜透析相关)腹膜炎较难区分,可能导致误诊。本文报告 1 例腹膜透析相关性肠瘘伴复发性腹膜炎患者。

病例介绍

1 例 44 岁男性因慢性肾脏病 5 期行腹膜透析治疗已超过 6 年。腹部 CT 和电子结肠镜检查提示阑尾窝处有邻近瘘管。拔除腹膜透析导管后,患者恢复良好,无并发症复发。

结论

本文报告 1 例腹膜透析罕见并发症。该患者肠瘘主要由复发性腹膜炎引起,导管拔除可控制腹膜炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b3b/7245831/1b7e37fc49e6/12876_2020_1303_Fig1_HTML.jpg

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